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  • 1.
    Boström, Martina
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Ernsth Bravell, Marie
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Björklund, Anita
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Sandberg, Jonas
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    How older people perceive and experience sense of security when moving into and living in a nursing home: [Hur äldre personer uppfattar och erfar trygghet i flytt till och boende i särskilt boende för äldre. En fallstudie]2017In: European Journal of Social Work, ISSN 1369-1457, E-ISSN 1468-2664, Vol. 20, no 5, 697-710 p.Article in journal (Refereed)
    Abstract [en]

    Sense of security is important throughout the lifespan not at least in advanced age with increased risks of functional declines and decreased social capital. Despite this, knowledge concerning older person’s perceptions and experiences of sense of security when moving into nursing homes is scarce. This study is a longitudinal, descriptive, exploratory case study with in-depth interviews and observations of three older persons in the age of 87, 88, and 91 years in a mid-sized municipality in the south of Sweden, in order to highlight how sense of security is experienced when moving into and living in a nursing home. Data were analysed using qualitative content analysis, which resulted in one main theme and four categories. The main theme, ‘Adaptation and sense of security’, indicates older persons’ need to adapt to the new context of the nursing home, and how this relates to their sense of security. The categories – ‘Control’, ‘Struggling for understanding’, ‘Lack of influence’, and ‘Grasping’ – suggest that older persons’ sense of security is reduced when they must adjust to routines without sufficient management and understanding. When able to maintain control over daily routines, and felt as a part of the new context, they perceived a sense of security.

  • 2. Carlander, Ida
    et al.
    Hellström, Ingrid
    Sandberg, Jonas
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Eriksson, Henrik
    The distrained masculinity: Death and dying from a gendered perspectiveIn: Nursing Inquiry, ISSN 1320-7881, E-ISSN 1440-1800Article in journal (Refereed)
  • 3. Carlander, Ida
    et al.
    Ternestedt, Britt-Marie
    Hellström, Ingrid
    Sahlberg-Blom, Eva
    Sandberg, Jonas
    Being Me and Being Us in a Family Close to Death at Home2011In: Qualitative Health Research, ISSN 1049-7323, E-ISSN 1552-7557, Vol. 21, no 5, 683-695 p.Article in journal (Refereed)
    Abstract [en]

    We used interpretive description to describe how everyday life close to death was experienced and dealt with in families with one member who had a life-threatening illness. We performed 28 individual, couple, and group interviews with five families. We found two patterns, namely, “being me in a family living close to death” and “being us in a family living close to death.” “Being me” meant that every individual in the family had to deal with the impending death, regardless of whether or not he or she was the person with the life-threatening illness. This was linked to ways of promoting the individual’s self-image, or “me-ness.” This pattern was present at the same time as the pattern of “being us,” or in other words, being a family, and dealing with impending death and a new “we-ness” as a group. “Striving for the optimal way of living close to death” was the core theme.

  • 4. Carlander, Ida
    et al.
    Ternestedt, Britt-Marie
    Hellström, Ingrid
    Sahlberg-Blom, Eva
    Sandberg, Jonas
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Four aspects of self-image close to death at home2011In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 6, no 2, 5931-5946 p.Article in journal (Refereed)
    Abstract [en]

    Living close to death means an inevitable confrontation with one’s own existential limitation. In this article, we argue that everyday life close to death embodies an identity work in progress. We used a narrative approach and a holistic-content reading to analyze 12 interviews conducted with three persons close to death. By illuminating the unique stories and identifying patterns among the participants’ narratives, we found four themes exemplifying important aspects of the identity work related to everyday life close to death. Two of the themes, named ‘‘Inside and outside of me’’ and ‘‘Searching for togetherness,’’ represented the core of the self-image and were framed by the other themes, ‘‘My place in space’’ and ‘‘My death and my time.’’ Our findings elucidate the way the individual stories moved between the past, the present, and the future. This study challenges the idea that everyday life close to impending death primarily means limitations. The findings show that the search for meaning, new knowledge, and community can form a part of a conscious and ongoing identity work close to death.

  • 5. Carlander, Ida
    et al.
    Ternestedt, Britt-Marie
    Sandberg, Jonas
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Hellström, Ingrid
    Constructing family identity close to death2013In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 3, no 5, 379-388 p.Article in journal (Refereed)
    Abstract [en]

    Daily life close to death involves physical, psychological, and social strain, exposing patients and their family members to major transitions affecting relational patterns and identity. For the individual family member, this often means sharing life with a changing person in a changing relationship, disrupting both individual identity and family identity. Our aim was to deepen the understanding of individual experiences that are important in constructing family identity close to death at home. We performed a secondary analysis of qualitative data collected through 40 interviews with persons with life-threatening illness and the family members who shared everyday life with them. The analysis resulted in interpretive descriptions which provided three patterns important for creating family identity, which we here call “we-ness” close to death. The patterns were: being an existential person, being an extension of the other, and being together in existential loneliness. Together, these three patterns seemed to play a part in the construction of family identity; we-ness, close to death. One important finding was the tension between the search for togetherness in “we-ness” while dealing with an existential loneliness, which seemed to capture an essential aspect of being a family of which one member is dying.

  • 6. Carlander, Ida
    et al.
    Ternestedt, Britt-Marie
    Sandberg, Jonas
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Hellström, Ingrid
    Dimensions of togetherness close to deathArticle in journal (Refereed)
  • 7.
    Dalteg, Tomas
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Sandberg, Jonas
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Malm, Dan
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare). Department of Internal Medicine County Hospital Ryhov Jönköping Sweden.
    Sandgren, Anna
    The Center for Collaborative Palliative Care, Linnaeus University, Växjö, Sweden.
    Benzein, Eva
    The Center for Collaborative Palliative Care, Linnaeus University, Växjö, Sweden.
    The heart is a representation of life: an exploration of illness beliefs in couples living with atrial fibrillation2017In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 26, no 21-22, 3699-3709 p.Article in journal (Refereed)
    Abstract [en]

    Aims and objectives: To explore illness beliefs in couples where one spouse has atrial fibrillation.

    Background: Beliefs are the lenses through which we view the world, guiding our behaviour and constructing our lives. Couples evolve an ecology of beliefs from their interaction whereby their actions and choices arise from their beliefs. Atrial fibrillation is a common cardiac arrhythmia that has implications for both patients and partners. A couple's illness beliefs play an important role in convalescence and illness management, and no previous studies have explored illness beliefs in couples living with atrial fibrillation.

    Design: A qualitative hermeneutic design.

    Methods: Data collection constituted in-depth interviews with nine couples (patient and partner together). Hermeneutic philosophy as described by Gadamer was used to interpret and to understand illness beliefs in couples living with atrial fibrillation.

    Results: The findings revealed both core illness beliefs and secondary illness beliefs. From the core illness belief 'The heart is a representation of life', two secondary illness beliefs were derived: atrial fibrillation is a threat to life and atrial fibrillation can and must be explained. From the core illness belief 'Change is an integral part of life', two secondary illness beliefs were derived: atrial fibrillation is a disruption in our lives and atrial fibrillation will not interfere with our lives. Finally, from the core illness belief 'Adaptation is fundamental in life', two secondary illness beliefs were derived: atrial fibrillation entails adjustment in daily life and atrial fibrillation entails confidence in and adherence to professional care.

    Conclusion: Couples' interaction has developed mutual illness beliefs regarding atrial fibrillation that guide them in their daily lives and influence their decisions. The adoption of a family-centred perspective in cardiovascular care settings is warranted. 

  • 8.
    Dalteg, Tomas
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Sandberg, Jonas
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Malm, Dan
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Sandgren, Anna
    Linnaeus University, The Center for Collaborative Palliative Care, Vaxjo, Sweden.
    Benzein, Eva
    Linnaeus University, The Center for Collaborative Palliative Care, Vaxjo, Sweden.
    The heart is a representation of life: an exploration of illness beliefs in couples living with atrial fibrillation2017In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 16, no Suppl. 1, S41-S41 p., 116Article in journal (Refereed)
    Abstract [en]

    Background: Beliefs are the lenses through which we view the world, guiding our behaviour and constructing our lives. Couples evolve an ecology of beliefs from their interaction whereby their actions and choices arise from their beliefs. Atrial fibrillation is a common cardiac arrhythmia that has implications for both patients and partners. A couple’s illness beliefs play an important role in convalescence and illness management, and no previous studies have examined illness beliefs in couples living with AF.

    Purpose: To explore illness beliefs in couples where one spouse has atrial fibrillation.

    Methods: Data collection constituted in-depth interviews with nine couples (patient and partner together). Hermeneutic philosophy as described by Gadamer was used to interpret and to understand illness beliefs in couples living with AF.

    Results: The findings revealed both core illness beliefs and secondary illness beliefs. From the core illness belief “Theheart is a representation of life,” two secondary illness beliefs were derived: atrial fibrillation is a threat to life and atrial fibrillation can and must be explained. From the core illness belief “Change is an integral part of life,” two secondary illness beliefs were derived: atrial fibrillation is a disruption in our lives and atrial fibrillation will not interfere with our lives. Finally, from the core illness belief “Adaptation is fundamental in life,” two secondary illness beliefs were derived: atrial fibrillation entails adjustment in daily life and atrial fibrillation entails confidence in and adherence to professional care.

    Conclusion: Couples’ interaction has developed mutual illness beliefs regarding atrial fibrillation that guide them in their daily lives and influence their decisions. The adoption of a family-centred perspective in cardiovascular care settings is warranted.

  • 9. Davies, Sue
    et al.
    Sandberg, Jonas
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Lundh, Ulla
    The entry to a nursing home: Residents’ and relatives’ experiences2000In: Care Services for Later Life: Transformations and Critiques / [ed] Warnes A.M., Warren L. & Nolan M., London: Jessica Kingsley Publishers, 2000Chapter in book (Refereed)
  • 10. Eriksson, Henrik
    et al.
    Sandberg, Jonas
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Röster från sidlinje: Form och norm i anhörigspelet2010In: Genusperspektiv på vård och omvårdnad / [ed] H. Strömberg & H. Eriksson, Stockholm: Liber, 2010Chapter in book (Other academic)
  • 11.
    Eriksson, Henrik
    et al.
    Department of Caring and Public Health Sciences, Mälardalen University.
    Sandberg, Jonas
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Transitions in Men’s Caring Identities: Placing a partner in a nursing home2008In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 3, no 2, 131-137 p.Article in journal (Refereed)
    Abstract [en]

    Objectives.  The aim of this study is to describe, from a gender identity perspective, the experiences of older men involved in the process of caring for a partner at home and the placement into a nursing home.

    Background.  Few studies have paid attention to the importance of gender when considering the social experiences of older men providing care for an ill spouse and finally placing a partner in a nursing home. Further understanding is much needed of how older men experience the process of caring for a spouse from a gender identity perspective.

    Design.  A qualitative constructivist approach was adopted for this study.

    Participants.  Data consists of interviews with seven men that have been informal carers and experienced the placement of their wife in a nursing home.

    Methods.  Interviews were analysed with a constructivist approach.

    Results.  The results indicate that men go through two transitions in their gender identity during the caregiving process and placement. From the mutual loving relationship of being a loving husband, the social responsibility of daily care of their wives changes the situation into that of being a caring husband, and finally with the move to a nursing home there is a transition from intimate care to a relationship based on friendship.

    Conclusions.  The results show that older caregiving men undergo a process involving a reconstruction of gender identity. To formally recognize men’s caring activities and to make them sustainable, we believe that men in an informal caring relationship need support.

    Relevance to clinical practice.  Nurses need to recognize the identity struggles resulting in sadness and suffering that are related to changes in men’s lives during the caregiving process. Understanding the dynamics and changes that occur when men take on a caring task is important for the development of their role as carers.

  • 12.
    Eriksson, Henrik
    et al.
    Mälardalens University, School of Health, Care and Social Welfare, Eskilstuna, Sweden.
    Sandberg, Jonas
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Ageing - living conditions and health. Jönköping University, School of Health Science, HHJ, Institute of Gerontology.
    Hellström, Ingrid
    Experiences of long-term home care as an informal caregiver to a spouse: gendered meanings in everyday life for female carers2013In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 8, no 2, 159-165 p.Article in journal (Refereed)
    Abstract [en]

    Aims and objectives: In this article, we explore the gender aspects of long-term caregiving from the perspective of women providing home care for a spouse suffering from dementia.

    Background: One of the most common circumstances in which a woman gradually steps into a long-term caregiver role at home involves caring for a spouse suffering from dementia. Little attention has been paid to examining the experiences and motivations of such caregivers from a feminist perspective.

    Methods: Twelve women, all of whom were informal caregivers to a partner suffering from dementia, were interviewed on the following themes: the home, their partner’s disease, everyday life, their relationship and autonomy. The results of these interviews were analysed in relation to gender identity and social power structures using a feminist perspective.

    Results: The findings of this study show that the informants frequently reflected on their caregiving activities in terms of both general and heteronormative expectations. The results suggest that the process of heteropolarisation in these cases can be an understood as a consequence of both the spouse’s illness and the resulting caring duties. Also, the results suggest that the act of caring leads to introspections concerning perceived ‘shortcomings’ as a caregiver. Finally, the results indicate that it is important to recognise when the need for support in day-to-day caring is downplayed.

    Conclusions: Women view their caregiving role and responsibilities as paramount; their other duties, including caring for themselves, are deemed less important. We stress that the intense commitment and responsibilities that women experience in their day-to-day caring must be acknowledged and that it is important for healthcare professionals to find mechanisms for providing choices for female caregivers without neglecting their moral concerns.

    Implications for practice: Female carers face difficulties in always living up to gendered standards and this need to be considered when evaluating policies and practices for family carers.

  • 13.
    Eriksson, Henrik
    et al.
    School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna, Sweden.
    Sandberg, Jonas
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Ageing - living conditions and health. Jönköping University, School of Health Science, HHJ, Institute of Gerontology.
    Holmgren, Jessica
    Pringle, Keith
    His helping hands-adult daughter's perceptions' of fathers with caregiving responsibility2013In: European Journal of Social Work, ISSN 1369-1457, E-ISSN 1468-2664, Vol. 16, no 2, 235-248 p.Article in journal (Refereed)
    Abstract [en]

    Women's position as informal carers has been taken for granted in social policy and social professions, while relatively few discussions have elaborated on caring as a later life activity for men and the impact on family care. This study explores the processes connected to informal caregiving in later life through the position of adult daughters of older fathers engaged with long-term caregiving responsibilities for a partner. A sample of eight daughters, with fathers having primary caregiving responsibility for their ill partners was recruited and in-depth interviews were carried out and analysed according to qualitative procedures. The daughters' descriptions of their relationships with their fathers show that being an older man who engages in caring can have a positive outcome on relations. Even if some of the daughters have doubts about their fathers “masculine authenticity”, all of them appear to cherish “his helping hands” as a carer and closer more intimate relationships with their fathers. Caring for an old and frail spouse may potentially present alternative ways of being a man beyond traditional ‘male activities’ and that caring might also sometimes involve a re-construction of gender identities. It is suggested that social work professionals may use a gendered understanding to assess and work strategically with daughters and other family members who support caring fathers.

  • 14. Eriksson, Henrik
    et al.
    Sandberg, Jonas
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Pringle, Keith
    “It feels like a defoliation…”: Older men’s notions of informal support as primary caregivers2008In: Nordic Journal for Masculinity Studies, ISSN 1890-2138, Vol. 3, no 1, 48-61 p.Article in journal (Refereed)
    Abstract [en]

    Little interest has been given to painting a broader picture of men’s relation tocaring and care giving activities and when it has, it has often tended to upholdstereotypic notions regarding men’s attitudes to caring activities. This articleexplores older men’s account of becoming and being primary caregivers as a resultof unexpected life events. By interviewing eleven older men in three focus groupsessions questions about masculinity and the cultural understanding about beingolder men in relation to caregiving and support was approached. In our result wedescribe the caregiving men’s social and personal changes as a consequences ofcaregiving as a defoliation process where the difficulty in upholding relationshipswith unconventional men and the caregiving men’s difficulty in upholdingrelations with people, who embrace hegemonic ideals about masculinity, is framingtheir lives as caregiving men.From this position caregiving men reach out and connect with other men whoshare the same experiences. We suggest that in the network of men who are, and isabout to become, primary caregivers, the principle of “paying it forward” seems tobe understood as the most valued support. Paying it forward help the men touphold their caring experience as valuable and gives the men a position as skilled.

  • 15. Hagren, Birger
    et al.
    Elvhage, Gudrun
    Sandberg, Jonas
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Män i välfärdsarbete2011Report (Other academic)
  • 16.
    Hellström, Ingrid
    et al.
    Social and Welfare Studies, Linköping University, Norrköping, Sweden.
    Eriksson, Henrik
    The Red Cross University College, Stockholm, Sweden.
    Sandberg, Jonas
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. Ageing - living conditions and health.
    Chores and sense of self: gendered understandings of voices of older married women with dementia2015In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 10, no 2, 127-135 p.Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    Marital relationships in dementia are forged between the person with dementia and the care partner, and such relationships have an impact on the way in which dementia is understood and experienced. The everyday work that underpins the relationship is usually divided between spouses and based on traditional divisions of household chores.

    AIMS AND OBJECTIVES:

    The aim was to describe how older women with dementia express the importance of their homes and their chores in everyday life.

    METHODS:

    Seven women with dementia, who were cohabiting with their husbands, were interviewed on up to five occasions at home during a five-to-six-year period on the following themes: the home, their dementia illness, everyday life, their relationships with their husbands and dignity and autonomy.

    RESULTS:

    The qualitative analysis showed three different patterns in the women's narratives: keeping the core of the self through the home, keeping the self through polarising division of labour and keeping the self through (re-) negotiations of responsibilities. The feeling of one's home and home-related chores is an essential way to express who you are.

    CONCLUSION:

    The women stated that household chores are the centre of their lives despite their dementia disease and that the home, even though it shrinks, still makes the women see themselves as an important person, namely the 'competent wife'.

    IMPLICATIONS FOR PRACTICE:

    Nurses need to be aware that 'doing gender' may be a means of preserving personhood as well as of sustaining couplehood in dementia.

  • 17. Hellström, Ingrid
    et al.
    Håkanson, Cecilia
    Eriksson, Henrik
    Sandberg, Jonas
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Development of older men's caregiving identities in caring for wives with dementiaIn: Geriatric Nursing, ISSN 0197-4572, E-ISSN 1528-3984Article in journal (Refereed)
  • 18.
    Hellström, Ingrid
    et al.
    Department of Social and Welfare Studies, Linköping University, Norrköping, Sweden.
    Håkansson, Cecilia
    Department of Health Care Science/Palliative Research Centre, Ersta Sköndal University College, Stockholm, Sweden.
    Eriksson, Henrik
    Department of Nursing and Care, The Swedish Red Cross University College, Stockholm, Sweden.
    Sandberg, Jonas
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Development of older men’s caregiving roles for wives with dementia2017In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 31, no 4, 957-964 p.Article in journal (Refereed)
    Abstract [en]

    This secondary analysis of qualitative interviews describes how older Swedish men approach the caregiver role for a wife with dementia, over time. An increasing number of male caregivers will become primary caregivers for partners living with dementia at home, and they will likely be caregivers for an extended period of time. It has been stated that caregiving experiences influence how older men think of themselves. The theoretical starting point is a constructivist position, offering an understanding of older caregiving men's constructions and reconstructions of themselves and their caregiver roles. Seven men, who were cohabiting with their wives, were interviewed on up to five occasions at home during a 5- to 6-year period. The findings comprise three themes; me and it, me despite it, it is me, depict how these men gradually take on and normalise the caregiving tasks, and how they develop and internalise a language based on their caring activities. The results provide understanding about the relationship between men as caregivers and how this influences them as individuals. By careful attention to each caregiving man's individual needs rather than making gendered assumptions about men and caring, the aim of the caregiver support for men might best target men's own meaning to the caring in their the everyday practices.

  • 19. Häggström Nordin, Elisabeth
    et al.
    Sandberg, Jonas
    Hanson, Ulf
    Tydén, Tanja
    “It’s everywhere!”: Thoughts and reflections about pornography among young people in Sweden2006In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 20, no 4, 386-393 p.Article in journal (Refereed)
    Abstract [en]

    Pornography is one of the most sought-after topics on the Internet, and is easily available for anyone, including children and adolescents. At youth centres, nurse-midwives have noticed that young people have different kinds of questions about sexual practices compared with a few years ago. The aim of this study was to gain an understanding of thoughts and reflections about pornography consumption, and its possible influence on sexual practices, among young women and men. The staff at a youth centre in a city in central Sweden asked the visitors if they had seen pornography and if they wanted to be interviewed about their experiences. Ten young women and eight men, aged 16–23 years, participated. In-depth interviews were performed and open-ended questions about pornography and sexuality were posed. The interviews were tape-recorded and transcribed verbatim. Data were analysed according to grounded theory. The core category ‘Living with the current sexual norm’ depicted how pornography created sexual expectations and demands, for instance, to perform certain sexual acts. The informants expressed contradictory feelings towards pornography and felt that sexuality was separated from intimacy. A moral attitude was described and examples of stereotypic gender roles were given. To deal with the current sexual norm, informants had different individual handling strategies and attitudes to pornography, namely liberal, normalization, distance, feminist or conservative. Limitations of this study were the small sample size and that results from a qualitative research study cannot be generalized. The results contribute to an understanding of how pornographic material can influence young peoples’ thoughts, reflections and sexual behaviour. This indicates the importance, for personnel at youth centres and schools, to discuss sexual behaviour and how sexuality is portrayed in pornographic material with young people.

  • 20.
    Håkanson, Cecilia
    et al.
    Ersta Sköndal University College, Stockholm, Sweden.
    Sandberg, Jonas
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Mirjam, Ekstedt
    KTH, Royal Institute of Technology, Stockholm, Sweden.
    Sarenmalm, Elisabeth Kenne
    Skaraborg Hospital, Skövde, Sweden.
    Mats, Christiansen
    Karolinska Institutet, Huddinge, Sweden.
    Joakim, Öhlén
    Ersta Sköndal University College, Stockholm, Sweden.
    Providing palliative care in a Swedish support home for people who are homeless2016In: Qualitative Health Research, ISSN 1049-7323, E-ISSN 1552-7557, Vol. 26, no 9, 1252-1262 p.Article in journal (Refereed)
    Abstract [en]

    Despite high frequencies of multiple, life-limiting conditions relating to palliative care needs, people who are homeless are one of the most underserved and rarely encountered groups in palliative care settings. Instead, they often die in care places where palliative competence is not available. In this qualitative single-case study, we explored the conditions and practices of palliative care from the perspective of staff at a Swedish support home for homeless people. Interpretive description guided the research process, and data were generated from repeated reflective conversations with staff in groups, individually, and in pairs. The findings disclose a person-centered approach to palliative care, grounded in the understanding of the person’s health/illness and health literacy, and how this is related to and determinant on life as a homeless individual. Four patterns shape this approach: building trustful and family-like relationships, re-dignifying the person, re-considering communication about illness and dying, and re-defining flexible and pragmatic care solutions.

  • 21.
    Håkanson, Cecilia
    et al.
    Ersta University College and Ersta Hospital, Stockholm, Sweden; Karolinska Institutet, Stockholm, Sweden .
    Seiger-Cronfalk, Berit
    Ersta University College and Ersta Hospital, Stockholm, Sweden; Karolinska Institutet, Stockholm, Sweden; Stord Haugesund University College, Norway.
    Henriksen, Eva
    Karolinska Institutet, Stockholm, Sweden; Stockholm County Council, Stockholm, Sweden.
    Norberg, Astrid
    Ersta University College and Ersta Hospital, Stockholm, Sweden; Umeå University, Umeå, Sweden.
    Ternestedt, Britt-Marie
    Ersta University College and Ersta Hospital, Stockholm, Sweden; Karolinska Institutet, Stockholm, Sweden; Stockholms Sjukhem foundation, Stockholm, Sweden.
    Sandberg, Jonas
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Ageing - living conditions and health. Ersta University College and Ersta Hospital, Stockholm, Sweden.
    First-Line Nursing Home Managers in Sweden and their Views on Leadership and Palliative Care2014In: Open Nursing Journal, ISSN 1874-4346, E-ISSN 1874-4346, Vol. 22, no 8, 71-78 p.Article in journal (Refereed)
  • 22. Håkansson, Cecilia
    et al.
    Seiger Cronfalk, Berit
    Henriksen, Eva
    Norberg, Astrid
    Ternestedt, Britt-Marie
    Sandberg, Jonas
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    First-line managers' views on leadership and palliative care in Swedish nursing homes2013In: Health & Social Care in the Community, ISSN 0966-0410, E-ISSN 1365-2524Article in journal (Refereed)
  • 23.
    Lind, Susanne
    et al.
    Department of Neurobiology, Neurosciences and Society, Karolinska Institute, Stockholm, Sweden.
    Wallin, Lars
    Department of Neurobiology, Neurosciences and Society, Karolinska Institute, Stockholm, Sweden.
    Brytting, Tomas
    Institute of Organisation and Worklife Ethics, Ersta University College, Stockholm, Sweden.
    Furst, Carl Johan
    Department of Clinical Science, Lund University, Lund, Sweden.
    Sandberg, Jonas
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Implementation of evidence-based palliative care in acute care hospitals: Obstacles and opportunities as described by politicians, hospital managers and health care professionals2016In: Palliative Medicine: A Multiprofessional Journal, ISSN 0269-2163, E-ISSN 1477-030X, Vol. 30, no 6, NP300- p., PO114Article in journal (Refereed)
    Abstract [en]

    Background: In high income countries, such as Sweden, a large proportion of all deaths occur at hospitals which is commonly not consistent with the desire of the patient and next-of-kin. A common way to translate knowledge into clinical practice is to create practice guidelines for different levels of the health care organization. During the last years, national clinical guidelines for palliative care and guidance from the NBHW have been published for the first time in Sweden. Hence, the aim of this study was to identify perceptions of obstacles and opportunities for implementation of evidence-based palliative care in acute care hospitals, as described by local politicians, chief medical officers and health care professionals.

    Method: Interviews were conducted with local politicians, chief medical officers and health care professionals and analysed through a directed qualitative content method, guided by The Consolidated Framework for Implementation Research.

    Results: Palliative care was commonly mentioned as a comprehensive way for alleviation of patients’ suffering with the overall goal for maintaining quality of life, especially in end of life care. Palliative care at the hospital was described by the staff as characterized by sudden disease, rapid changes back and forth between life and death and difficulties to predict the outcome. The environment, the culture, poor communication and poor cooperation in the work team were described as obstacles for implementation. The informants mentioned the newly published documents as important but the knowledge about the content varied a lot. A newly formed internal group with the assignment to develop the palliative care at the clinic was emphasized by all health care professionals as a good opportunity to get support and local guidelines.

    Conclusion: An active process at different levels in the health care organization is important for a successful implementation of evidence-based palliative care in acute care hospitals.

  • 24.
    Lind, Susanne
    et al.
    Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Flemingsberg, Sweden.
    Wallin, Lars
    Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Flemingsberg, Sweden.
    Brytting, Tomas
    The Institute of Organisation and Worklife Ethics, Ersta Sköndal Bräcke University College, Stockholm, Sweden.
    Fürst, Carl Johan
    Institute for Palliative Care at Lund University and Region Skåne, Lund, Sweden.
    Sandberg, Jonas
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology.
    Implementation of national palliative care guidelines in Swedish acute care hospitals: A qualitative content analysis of stakeholders' perceptions2017In: Health Policy, ISSN 0168-8510, E-ISSN 1872-6054, Vol. 121, no 11, 1194-1201 p.Article in journal (Refereed)
    Abstract [en]

    In high-income countries a large proportion of all deaths occur in hospitals. A common way to translate knowledge into clinical practice is developing guidelines for different levels of health care organisations. During 2012, national clinical guidelines for palliative care were published in Sweden. Later, guidance for palliative care was issued by the National Board of Health and Welfare. The aim of this study was two-fold: to investigate perceptions regarding these guidelines and identify obstacles and opportunities for implementation of them in acute care hospitals. Interviews were conducted with local politicians, chief medical officers and health professionals at acute care hospitals. The Consolidated Framework for Implementation Research was used in a directed content analysis approach. The results showed little knowledge of the two documents at all levels of the health care organisation. Palliative care was primarily described as end of life care and only few of the participants talked about the opportunity to integrate palliative care early in a disease trajectory. The environment and culture at hospitals, characterised by quick decisions and actions, were perceived as obstacles to implementation. Health professionals' expressed need for palliative care training is an opportunity for implementation of clinical guidelines. There is a need for further implementation of palliative care in hospitals. One option for further research is to evaluate implementation strategies tailored to acute care. 

  • 25. Lundh, Ulla
    et al.
    Sandberg, Jonas
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Health care and social service for older people in Sweden: Implications for nursing1999In: Gerontological Nursing Issues for the 21st Century : A multidisciplinary Dialogue Commemorating the International Year of Older Persons / [ed] S.H. Gueldner &L.W. Poon, Washington: Sigma Theta Tau International , 1999Chapter in book (Other academic)
  • 26.
    Lundh, Ulla
    et al.
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Sandberg, Jonas
    Nolan, Mike
    ‘I don’t have any other choice’: Spouses’ experiences of placing a partner in accommodation for older people in Sweden2000In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 32, no 5, 1178-1186 p.Article in journal (Refereed)
    Abstract [en]

    The main aim of this paper is to consider the experiences of Swedish spouses who have placed a partner in a care home for older people. Data were gathered from semi-structural interviews with 14 spouses (11 wives and 3 husbands) who had been involved in a care home placement within the previous 6 months. The results reported here are from the first component of a larger grounded theory study, the aim of which is to explore, describe and understand the experience of care home placement from a variety of perspectives and to identify the implications for policy and practice in Sweden. The focus here is on the experience of spouses, relating to the decision-making process, the move into care and subsequent contact with the care home. Four themes emerged from the data – making the decision, making the move, adjusting to the move and reorientation. The results show a lack of planning for the elder person’s entry to a care home, and professional dominance of this stage of the process. The largely ambivalent emotional responses to the move that spouses experience and the difficulties in initiating and sustaining relationships with staff in the home are discussed in the light of previous research.

  • 27.
    Sandberg, Jonas
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Att placera sin make eller maka på särskilt boende: (åter)-skapa roller och relationer2004In: Att vara äldre ”…man har ju sina krämpor…” / [ed] Edberg, A-K. & Blomqvist, K., Lund: Studentlitteratur, 2004Chapter in book (Other academic)
  • 28.
    Sandberg, Jonas
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Placing a partner in a nursing home – report from a pilot study1998Conference paper (Refereed)
  • 29.
    Sandberg, Jonas
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Placing a partner in a nursing home-reconstructing roles and relationships2006In: Changing Professional Identities and Boundaries in Health and Social Care: European Perspectives, 2006Conference paper (Other academic)
  • 30.
    Sandberg, Jonas
    Linköping University, Department of Neuroscience and Locomotion, Geriatrics.
    Placing a spouse in a care home for older people: (Re)-Constructing Roles and Relationships2001Doctoral thesis, comprehensive summary (Other academic)
  • 31.
    Sandberg, Jonas
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Young core leaders of civil society groups development program: Some personal reflections2008In: Macrocosm, ISSN 1072-5466, Vol. 5, no 82, 6-7 p.Article in journal (Other academic)
  • 32.
    Sandberg, Jonas
    et al.
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Eriksson, Henrik
    Att lära sig vårda på äldre dar2010In: Vårdpedagogiska utmaningar / [ed] B. Johansson & S. Bentling, Stockholm: Liber, 2010, 248-266 p.Chapter in book (Other academic)
  • 33.
    Sandberg, Jonas
    et al.
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Eriksson, Henrik
    Bortom omsorgsnormen: Anhörigvård i en genusteoretisk belysning2010In: Äldres hälsa och ohälsa: en introduktion till geriatrisk omvårdnad / [ed] A. Ekwall, Lund: Studentlitteratur, 2010, 63-74 p.Chapter in book (Other academic)
  • 34.
    Sandberg, Jonas
    et al.
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Eriksson, Henrik
    From alert commander to passive spectator: older male carers' experience of receiving formal support2009In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 4, no 1, 33-40 p.Article in journal (Refereed)
    Abstract [en]

    The aim was to describe older male carers' experience of receiving formal support.

    Background. To older male carers, creating new roles seems to be important. Their need for support in their caregiving is poorly understood.

    Design. A qualitative approach with a critical perspective on men and masculinities was used.

    Participants. Focus groups comprising a total of 11 men were used.

    Methods. Qualitative content analysis was adopted.

    Results. Three categories of response were found: `using ad hoc solutions for maintaining a protective environment', `coping but being left behind' and `recapturing the caregiving role'.

    Discussion. Not only the quantity of support services offered to older male carers but also their quality dimension, based on a genuine understanding of the men's support needs, must be addressed.

    Conclusions. Professional caregivers attempt to relieve the men of their care obligations entirely. A reciprocal arrangement involving the men as partners, instead, may help them to regard their caring experience as valuable, which is important to their self-image.

    Relevance to clinical practice. These men's socially based networks need to be recognized by professional caregivers as important, to reframe the men's identity and notion of masculinity.

  • 35.
    Sandberg, Jonas
    et al.
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Eriksson, Henrik
    Makt, genus och identitet2013In: Palliativ vård: Begrepp och perspektiv i teori och praktik / [ed] Birgitta Andershed, Britt-Marie Ternestedt & Cecilia Håkanson, Studentlitteratur, 2013Chapter in book (Other academic)
  • 36.
    Sandberg, Jonas
    et al.
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Eriksson, Henrik
    Men as informal caregivers in late life2007Conference paper (Refereed)
  • 37. Sandberg, Jonas
    et al.
    Eriksson, Henrik
    “The hard thing is the changes…”: The importance of continuity for older men caring for their wives2007In: Quality in Ageing and Older Adults, ISSN 2044-1827, Vol. 8, no 2, 5-14 p.Article in journal (Refereed)
  • 38. Sandberg, Jonas
    et al.
    Eriksson, Henrik
    Holmgren, Jessica
    Pringle, Keith
    Keeping the family balance: Adult daughters’ experiences of roles and strategies when supporting caring fathers2009In: European Journal of Social Work, ISSN 1369-1457, E-ISSN 1468-2664, Vol. 12, no 2, 233-245 p.Article in journal (Refereed)
    Abstract [en]

    The Scandinavian countries represent a progressive approach to gender equality and transitions of traditional gender roles but little attention has been paid to gender equality in old age and how normative constructions of gender intersect in the lives of family carers. The aim of this study was to understand how adult daughters experience their roles and strategies when supporting fathers caring for an ill mother. A sample of eight daughters shared their experiences through in-depth interviews. The findings show that the daughters provide substantial and crucial effort and are intimately involved in the caring for their father and the sole contributors towards the emotional support of their fathers. They tend to devote a lot of energy towards picturing their family as ‘normal’ in terms of the family members adopting traditional roles and activities inside as well as outside the family context. In conclusion, the lack of understanding about gender as a ‘norm producer’ is something that needs to be further elaborated upon in order for professionals to encounter norm-breaking behaviours. The daughters’ position as family carers is often assumed and taken for granted since the intersecting structures that impact on the situations of the daughters are largely invisible.

  • 39.
    Sandberg, Jonas
    et al.
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Lundh, Ulla
    Health care and social service for older people in Sweden1997Conference paper (Refereed)
  • 40. Sandberg, Jonas
    et al.
    Lundh, Ulla
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Nolan, Mike
    Moving into a care home: The role of adult children in the placement process2002In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 39, no 3, 353-362 p.Article in journal (Refereed)
    Abstract [en]

    Admission of an older person to a care home is widely recognised as a very stressful period for the family and one which, despite community care policy, is likely to be an increasingly common experience. Although there is a growing research base in this area, there have been few studies on the role of adult children in supporting their parents during this difficult transition. This paper reports on the third stage of a grounded theory study conducted in Sweden which explored the part played by adult children in the placement process. Data were collected from 13 adult children using in-depth semi-structured interviews and the results are compared with themes previously derived from interviews with 26 spouse carers. The analysis reveals important overlaps and differences and suggests the need for further research exploring the dynamics of the placement process.

  • 41. Sandberg, Jonas
    et al.
    Lundh, Ulla
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Nolan, Mike
    Placing a spouse in a care-home: the importance of keeping2001In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 10, no 3, 406-411 p.Article in journal (Refereed)
    Abstract [en]

    Despite a universal policy of community care, the number of frail older people entering care homes is likely to increase in the future. There have been relatively few studies exploring the experience of spouses who have placed a partner in care. Due to a lack of preparation, the placement process is often ad hoc, with little attention being given to spouses' emotional reactions or their efforts to maintain their relationship with their partner. The relationship between care home staff and families is often superficial and strained. There is a need for more proactive efforts to facilitate a partnership between care home staff and families.

  • 42.
    Sandberg, Jonas
    et al.
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Lundh, Ulla
    Nolan, Mike
    (Re)-constructing relationships: the impact of nursing home placement2003In: Partnerships in Family Care: Understanding the caregiving career / [ed] Nolan M., Lundh U. Grant G. & Keady J., Buckingham: Open University Press, 2003Chapter in book (Refereed)
  • 43. Sandberg, Jonas
    et al.
    Nolan, Mike
    Lundh, Ulla
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    ’Entering a new world’: Emphatic awareness as the key to positive family/staff relationships in care homes2002In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 39, no 5, 507-515 p.Article in journal (Refereed)
    Abstract [en]

    Despite an almost universal policy of community care, placing a relative in a care home will be an increasingly common event as population ageing continues. Studies suggest that most families wish to remain involved in care following placement but that they often experience difficulties in establishing relationships with staff. This paper reports on the fifth phase of a Swedish study exploring the experience of placement from a temporal perspective and including the views of all the key actors (relatives, staff in the community, staff in care homes). The focus here is placed on the perceptions of care home staff and their perceived role in relation to spouses who have recently placed a partner. The study adopted a grounded theory approach and data were collected from in-depth interviews with 16 staff members of varying grades and positions. Analysis of the data suggested 3 levels of awareness amongst staff: empathic awareness, guarded awareness and limited awareness. The characteristics of empathic awareness are outlined and its implications briefly considered.

  • 44.
    Sandberg, Jonas
    et al.
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Nolan, Mike
    Lundh, Ulla
    The role of community staff in care home placement in Sweden2002In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 11, no 4, 488-497 p.Article in journal (Refereed)
    Abstract [en]

    The role of community staff in placing a relative in a care home is a relatively unexplored area of practice. Interviews with a variety of community staff in Sweden suggest that they play a significant role in helping family carers, particularly spouses, research the decision about the need for placement. This role can include recognition that placement is required (seeing the need), initiating and sustaining discussions about placement (sowing the seed and nurturing the seed) and legitimating the decision. However, once the decision has been made relatively little attention is given to the emotional consequences of the move and attention is focused largely on instrumental aspects. Despite showing sensitivity in the decision-making phase, community staff could do more to help carers deal with the guilt they experience and to initiate contact with the care home.

  • 45.
    Sandberg, Jonas
    et al.
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Pohlkamp, Lilian
    Mental health and recovery over time after losing a relative in the M/S Estonia maritime disaster2013Conference paper (Refereed)
  • 46.
    Siebmanns, Sandra
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Ulander, M.
    Linkoping University Hospital, Department of clinical neurophysiology, Linkoping, Sweden.
    Sandberg, Jonas
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Johansson, Linda
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Johansson, P.
    Linkoping University Hospital, Department of Cardiology and Department of Medical and Health Sciences, Linkoping, Sweden.
    Broström, Anders
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Insomnia in patients with cardiovascular disease - a review of causes, consequences and nursing interventions2017In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 16, no Suppl. 1, S31-S31 p.Article in journal (Refereed)
    Abstract [en]

    Introduction: Insomnia is defined as a subjective complaint of difficulty to initiate sleep, difficulty to maintain sleep, and early morning awakenings that occur at a minimum of 3 nights per week for 3 months. The prevalence of insomnia in the general adult population is estimated to 12–20%. The prevalence is even higher among those with cardiovascular disease (CVD). Insomnia has a significant impact on the individual’s health and quality of life.

    Aim: To examine causes, consequences and nursing interventions for insomnia in patients with CVD.

    Design: Literature review.

    Method: Electronic search through PubMed and Cinahl for studies published 2001-2016. Insomnia, CVD, causes, consequences, interventions and nurse-led intervention were used as keywords. Detected duplicates, irrelevant studies and others (i.e., editorials, letters) were removed. “Insomnia and CVD” resulted in 214 hits, “insomnia and CVD and causes” in 394 hits, “insomnia and CVD and consequences” in 35 hits, and “insomnia and CVD and interventions” resulted in 51 hits.

    Results: Insomnia causes impaired daytime functioning, poorer cognitive function and a feeling of isolation. The pathophysiological consequences of insomnia are associated with increased risk for arteriosclerosis and CVD (i.e., caused by an increased inflammatory processes). Pharmacological treatment for insomnia have been used for some time (i.e., sedative, hypnotics and antidepressant), but there are concerns about tolerance and dependence, as well as other side effects (i.e., falls, cognitive changes and unusual sleep behaviours) which requires a thorough risk and benefit analysis before prescription. Non-pharmacological treatments such as Cognitive behavioural therapy (CBT) and internet-based CBT (I-CBT) for insomnia, led by therapists, is a less expensive intervention used in previous studies for othe rpatient groups. Despite positive results for both CBT andI-CBT (i.e., improved performance, increased quality of life and reduced symptom burden) in these studies no nurse-led interventions (i.e., of any type) intended for patients with CVD and insomnia were found.

    Conclusion: I-CBT for insomnia seems to be an accessible and effective treatment for other patient groups. The lack of nurse-led interventions, highlights the need for future studies in patients with CVD and insomnia.

  • 47.
    Siebmanns, Sandra
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Ulander, M.
    Linkoping University Hospital, Department of clinical neurophysiology, Linkoping, Sweden.
    Sandberg, Jonas
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Johansson, Linda
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology.
    Johansson, P.
    Linkoping University Hospital, Department of Cardiology and Department of Medical and Health Sciences, Linkoping, Sweden.
    Broström, Anders
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Internet-based Intervention to treat insomnia in patients with cardiovascular disease2017In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 16, no Suppl. 1, S75-S75 p.Article in journal (Refereed)
    Abstract [en]

    Introduction: Insomnia (i.e., trouble initiating sleep,maintaining sleep or difficulties getting enough sleep) is a prevalent problem among patients with cardiovascular disease (CVD). It is associated with physical and mental symptoms such as impaired daytime functioning, worries and depressive symptoms. Recent studies in other patient groups have described Internet-based Cognitive behavioral treatment (I-CBT) as a promising accessible and cost effective intervention. Few if any studies are conductedin CVD patients with insomnia despite the possibility of reduced symptom burden, reduced cardiovascular morbidity and improved quality of life (QoL).

    Aim: To describe the design, content and measures in theHit-IT study, an intervention developed to treat insomnia in patients with CVD.

    Design: An explorative design with 1 year followup including 200 primary care patients with CVD and insomnia from 4 centers. Patients will be randomized to 9 weeks of I-CBT, or to a control group receiving internetbased sleep hygiene without support.

    CONTENT: The I-CBT intervention starts with a 1 week introduction, 2 weeks of psychoeducation (i.e., CVD and insomnia), followed by a 6 weeks treatment part (i.e., sleep hygiene, stimulus control and sleep restriction). Participants can communicate with a nurse and receive feedback during treatment. A psychologist will act as back-up.

    MEASURES: Questionnaires will be administered at baseline, during and post intervention at 6 and 12 months’. The questionnaires will focus on e.g., educational effects, as well as on effects regarding symptoms; sleep/insomnia (PSQI, ISI, ESS, sleep diary), depressive symptoms (PHQ-9), as well as QoL (SF12). The participants’ experience of the program will be explored by repeated interviews (at baseline, after 3 weeks, 6 weeks and after the intervention).

    Conclusion: Depending on its effectiveness a nurseled I-CBT program can be a possible tool for insomnia treatment in cardiovascular care.

  • 48. Stenwall, Ewa
    et al.
    Eriksdotter Jönhagen, Maria
    Sandberg, Jonas
    Fagerberg, Ingegerd
    The older patient's experience of encountering professional carers and close relatives during a confusional state: an interview study2008In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 45, no 11, 1577-1585 p.Article in journal (Refereed)
  • 49. Stenwall, Ewa
    et al.
    Sandberg, Jonas
    Eriksdotter Jönhagen, Maria
    Fagerberg, Ingegerd
    Encountering the older confused patient: professional carers’ experiences2007In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 21, no 4, 515-522 p.Article in journal (Refereed)
    Abstract [en]

    The study’s rationale:  Confusion is a common condition among older patients and often a fearful experience. Opinions vary as to how to communicate with and care for confused patients and professional carers often find the patients’ situation almost as distressing as the patients’ themselves do.

    Aims and objectives:  The aim of this study was to describe professional carers’ experiences of their encounters with older confused patients.

    Methodological design and justification:  Data was collected from interviews with 10 professional carers working on a ward specializing in the care of older confused patients. A descriptive phenomenological research approach was used to gather knowledge of professional carers’ experiences of encounters with older confused patients.

    Ethical issues and approval:  A Regional Board of Research Ethics granted ethical permission for the study. The appropriate ethical principles were followed. The participants were contacted personally and received a letter providing information on the study. Written consent was requested before the interview. If needed, the participants were able to get in contact with the staff health service for a follow-up after the interview. Names or places have been changed in order to ensure confidentiality.

    Results:  The encounter with the confused patient is experienced as an encounter with an unfamiliar person, where the patients’ actions and words are unforeseeable and with a lack of immediate trust. The essential meaning is further illuminated by the meaning constituents: the unforeseeable encounter, always being on guard and using oneself as a tool.

    Relevance to clinical practice:  This paper focuses on the importance of encouraging professional carers to pay attention to the complexity of the encounter with the confused patient, reflecting upon their own behaviour within these encounters and the importance of knowledge of the patient’s preferred senses and life stories. Caring for confused patients involves a great responsibility where both the professional carers and the patients are vulnerable and exposed.

  • 50. Stenwall, Ewa
    et al.
    Sandberg, Jonas
    Eriksdotter Jönhagen, Maria
    Fagerberg, Ingegerd
    Relatives' experiences of encountering the older person with acute confusional state: experiencing unfamiliarity in a familiar person2008In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 3, no 4, 243-251 p.Article in journal (Refereed)
    Abstract [en]

    Aims and objectives.  The aim was to understand the lived experience of close relatives encountering older persons with acute confusional state.

    Background.  Little is known about relatives of patients with acute confusional state and their experiences while encountering a family member exhibiting acute confusional state.

    Design.  A descriptive phenomenological research approach was used.

    Methods.  Data were collected by interviewing 10 close relatives of older people with acute confusional state at two hospital wards.

    Results.  Relatives experience the encounter as encountering a familiar person who has suddenly become unfamiliar, struggling to separate the familiar from the unfamiliar and trying to understand the causes of acute confusional state and the behaviour of the person. Six constituents illuminate the phenomenon: ‘change in the other person’, ‘rapid and unexpected changes’, ‘experiencing insecurity in the encounter’, ‘trusting or mistrusting the other person’, ‘experiencing loss’ and ‘experiencing exposure’.

    Relevance to clinical practice.  It is important for professional carers to support relatives on how to encounter the person with acute confusional state, and to co-operate with relatives to gain knowledge about the unique person behind the acute confusional state.

    Conclusion.  Relatives’ difficulties in dealing with strong emotions evoked within the encounter, experiencing limitation and lack of trust is essential knowledge for professional carers in all care settings.

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